Hi, I am not sure how helpful this is, but I want to throw it out, hoping you see this before you see your new neuro-op doc. I had severe TED. Lots of double vision. BUt the treatment for that is usually strabismus surgery, for the very reason you mentioned about the muscles of the eye. And yes, the muscles are shortened and thickened, as you said. From my experience, and from what I know about steroids, any steroids for swelling and inflammation in TED is a temporary fix, hoping to reduce the discomfort, and perhaps improve the vision for a little while. But it is a stopgap measure, not a permanent treatment.
I'd like to tell you that strabismus surgery was the VERY BEST THING that happened in my whole miserable, hellish TED experience. Please mention this to the neuro op tomorrow, including the purpose of steroids.
I did have them, but they were oral and IV, to reduce pressure on my optic nerve, until I could have an orbital decompression to relieve the pressure on my optic nerve, thus preserve my vision. My own neuro op doc does not believe in direct steroid injections in the eye for TED. But I am sure if 20 doctors are asked their opinion, the answers would be diverse, and not in agreement.
TED 2008-present. OD for pressure on optic nerve 02/02/10
Eye muscle surgery 09/23/10 Upper eyelid surgery 02/01/11
Lower eyelids with grafts from palate, 10/5, 10/25/11
Graves dx/thyroidectomy 1959-Synthroid from 1980